Honey, it's time: Where to go when labour sets in
Deciding where to give birth is one of the biggest decisions you’ll make during pregnancy. And it’s a luxury that the decision even exists; generations ago, the only choice was at home, far from potentially life-saving doctors, and in the not-so-recent past, the only option was a hospital, far from loved ones and even consciousness.
Today, women are free to labour and give birth where they choose, but with that freedom comes the need to do your research: where is the best place for you and your baby?
There are three main options available, all of which carry their own set of pros and cons. Should you head to the birthing pool in your living room or to the local labour and delivery ward? What about a birthing centre? The decision is an intensely personal one, and it’s one that will create ripple effects throughout your labour, childbirth, and postpartum experience. Let’s start at home, which is where you’ll probably be when labour sets in, anyway.
Home
Pros
- The one-on-one attention you’ll get from the midwife/midwives who attend your home birth cannot be beat. They’ll have no one to focus on (or, if you prefer, pretend not to notice) but you.
- Your labour may progress faster if you are in a comfortable, familiar environment.
- You are more likely to get through labour without any interventions at all, which is best for you and your baby whenever possible.
- You won’t have to endure a seriously uncomfortable car ride to the hospital or birth centre.
- When the birth is over, you’ll have the luxury of staying right where you are for as long as you want --- hours, days, weeks, months!
Cons
- The possibility of having to transfer to a hospital, though rare, could be traumatic. A licensed midwife will recognize signs of distress well before they are threatening and will take appropriate action, but the physical transport and the transfer of care might be devastating.
- You’ll likely be asked to provide many of your own supplies, from a pan to put the placenta in to a plastic sheet for your bed. (Don’t underestimate the luxury of a hospital or birth centre’s unlimited supply of warmed blankets for you and Baby, either!)
- If you’re planning a water birth at home, the capacity of your hot water tank could be a concern. How long will it take to fill the tub, and can you wait that long?
- Depending on where you live, the prenatal care and home birth services provided by a midwife can be a substantial investment that may or may not be covered by insurance.
- Resistance from family may be a consideration for many women who want to have a home birth. If your partner isn’t on board, s/he may be comforted to hear the research directly: numerous studies have demonstrated that a home birth is actually safer than a hospital for low-risk women. Birth Source also stocks a great DVD, Homebirth Dads, that could come in handy to soothe nerves.
Birth Centre
Pros
- Mostly located inside hospitals, birth centres are great halfway houses for the labouring woman who want as natural a birth as possible, but who also wants relatively easy access to emergency medical equipment. (There are freestanding birth centres around, too, which remove the hospital completely from the equation.)
- Birthing centres have large, private rooms with all the amenities a labouring woman could hope for (large showers, deep tubs, low lighting, and comfortable beds, to name just a few).
- Staffed by midwives, birthing centres are more likely to follow your direction than to expect you to follow theirs. This perceptive shift will be important when it comes to things like routine interventions, newborn procedures, and breastfeeding.
Cons
- If a hospital transfer is required, you’ll want to consider how far it is from the birthing centre and if you’re comfortable with that distance.
- Your options for pain relief will be limited, though not non-existant. (Epidurals aren’t usually an option, but laughing gas is a popular alternative.)
- Depending on where you live, cost may be a factor.
Hospital
Pros
- The latest and greatest medical technology will be at your disposal.
- Hospitals are the safest environments for labouring women who have had high-risk pregnancies.
- At major hospitals, pediatricians and obstetricians are available around the clock should the need arise for infant or mother examination.
Cons
- Statistically speaking, you are more likely to undergo several interventions, from Pitocin-fueled induction to Caesarean section delivery, in a hospital environment.
- Hospitals can be very busy, hectic places, which may affect your concentration during labour. We strongly recommend hiring a doula for extra support if you choose to give birth in a hospital, as she will provide the consistency of care, dedicated support, and mind-over-matter focus you’ll benefit from at every stage.
- The foreign environment may slow down your labour.
- Because hospital staffers work in shifts, you may not have the opportunity to meet in advance the person or team who delivers your baby.
- You will probably have far less privacy than you’d like, both in labour and while recovering.
- Standard hospital protocols (and the liabilities associated with them) may make it difficult for you to advocate for the birth you want.
